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Hamstring Tendonitis

Are you suffering from hamstring tendonitis? Are you eager to return back to your normal routine activities without pain? In this article, we will provide you with all the information you need to know about the condition and how to recover from it as fast as possible.

What is hamstring tendonitis?

There are three muscles in each hamstring: the semimembranosus, semitendinosus, and biceps femoris. The hamstring muscle group runs all the way down the back of the thigh. The two actions they perform are flexion of the knee and extension of the hip. The muscles use soft tissue structures called tendons to attach to bones. There are two sets of hamstring tendons. The distal set attaches into the top of the lower leg, and the proximal set attaches into the pelvis via the ischial tuberosity (sit bone). When the tendons are inflamed it is called hamstring tendonitis.

Symptoms of hamstring tendonitis

  • Swelling and inflammation at the back of the knee joint (distal hamstring tendinopathy) or the lower gluteal region (proximal hamstring tendinopathy).
  • A burning sensation either in the tendon of referred to the muscle. This can be due to scar tissue from the hamstring tendon irritating the sciatic nerve.
  • Muscle stiffness.
  • Pain when flexing the knee or extending the hip.
  • Throbbing.
  • Pain during weight-bearing activities.



Repetitive activities performed for long periods such as running or cycling can cause inflammation to build up in the hamstring tendons. This is particularly common in individuals who do not stretch their hamstring muscles regularly.

Muscle tension or weakness

When the hamstring muscles are tense or weak, they are unable to absorb shock efficiently during weight-bearing activities. Some of this shock then gets transferred into the tendons, which can lead to inflammation and small micro-tears.


If the pelvis or ankles aren’t in proper alignment, it can cause a change in your gait cycle. This change forces your hamstring tendons to function at an angle that they weren’t designed to function. Over time they can become inflamed.

Previous hamstring injuries

A previous injury to the hamstring muscle can leave scar tissue where it has attempted to heal. This scar tissue can affect the function of the tendons and cause them to have to work harder during certain movements.

Ligament laxity

If the ligaments in the knee are weak, it causes the joint to become unstable. This instability forces the surrounding tendons to work harder to stabilise the knee during movement, causing either tendonitis or other hamstring injuries.

Risk factors

– Athletes that do not stretch, warm-up, or have regular physical therapy.

– Age: blood flow to the hamstring tendon starts to decline with age. This causes the hamstring to become brittle and reduces its ability to absorb force very well.

Treatment options for hamstring tendonitis


The structures in and around the hamstring tendon have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of a regenerative  into these structures to provide a direct supply of what is needed to heal them and provide pain relief.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.


A physical therapist at a sports medicine clinic will prescribe a rehabilitation program that involves both strengthening exercises and stretching exercises to help improve the health of the hamstring muscle. Isometric strengthening exercises are the most effective for hamstring tendonitis. A treatment plan to improve the health of the muscle can help to take tension away from the tendon to give it a chance to heal.


Anti-inflammatory medications such as ibuprofen can provide temporary relief but they are not recommended to take long term.


Your practitioner will start by taking a detailed case history and ask specific questions about how the symptoms started. They will then perform some manual movement tests they will help to indicate whether a scan is needed of not. Either an ultrasound scan or MRI scan can help to diagnose hamstring tendonitis. Symptoms of ischiogluteal bursitis can mimic the symptoms of hamstring tendinitis so a scan will help to determine which issue is causing the problem. An x-ray cannot diagnose a problem in a tendon.


– It is important to warm-up and perform a hamstring stretch before and after physical activity.

– Performing regular hamstring exercises such as hamstring curls can help to prevent a re-injury.

– For someone who performs a lot of physical activity then it is recommended to have a regular sports massage at a physical therapy clinic.

– If an individual has had a history of tendinitis or hamstring strains then they will benefit from having their pelvic alignment assessed by an osteopath or chiropractor. This helps to make sure that their body weight is evenly distributed between both hamstring muscles during weight-bearing activities. A physiotherapist that assesses walking and running gait may also be able to help.

Frequently asked questions

How long does it take for hamstring tendonitis to heal?

It can take up to 6 weeks for the condition to heal. The length of time it takes depends on the severity of the inflammation and how long it has been present.

Is walking good for hamstring tendonitis?

Walking can be good as it helps to strengthen muscles in the hamstring and promote blood flow into the tendon. The only circumstance that it isn’t beneficial is if the pain from the tendonitis is causing an individual to limp, as limping can cause problems in other areas of the body.

Can sitting cause hamstring tendonitis?

If an individual sits for a prolonged amount of time without performing many walking activities in the day then it can lead to inflammation of the hamstring tendons. Sitting on a hard chair can contribute to the condition.

Is it good to stretch a pulled hamstring?

Stretching can be good for a pulled hamstring but it has to be performed in a certain manner. The stretch should be performed until only a slight pull is felt and then needs to be held for 15-20 seconds.




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